• Childhood Kidney Diseases
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• v.25 no.2
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• pp.71-77
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• 2021

Childhood hypertension (HTN) has become a significant public health issue because of the increased risk of cardiovascular disease in adulthood. However, childhood HTN is underrecognized and underdiagnosed in clinical practice. The European Society of Hypertension in 2016 and the American Academy of Pediatrics (AAP) in 2017 published updated guidelines for the screening, prevention, and management of pediatric HTN. There were notable differences between the two guidelines as well as many similarities. The updated AAP guidelines have clarified and simplified the recommendations for screening, diagnosis, and treatment of childhood HTN based on current evidence. This review highlights the important developments in both guidelines, focusing on recent advances in the classification and treatment of childhood HTN.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.5
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• pp.467-472
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• 2015

Histone deacetylase (HDAC) has been recognized as a potentially useful therapeutic target for cardiovascular disorders. However, the effect of the HDAC inhibitor, trichostatin A (TSA), on vasoreactivity and hypertension remains unknown. We performed aortic coarctation at the inter-renal level in rats in order to create a hypertensive rat model. Hypertension induced by abdominal aortic coarctation was significantly suppressed by chronic treatment with TSA (0.5 mg/kg/day for 7 days). Nicotinamide adenine dinucleotide phosphate-driven reactive oxygen species production was also reduced in the aortas of TSA-treated aortic coarctation rats. The vasoconstriction induced by angiotensin II (Ang II, 100 nM) was inhibited by TSA in both endothelium-intact and endothelium-denuded rat aortas, suggesting that TSA has mainly acted in vascular smooth muscle cells (VSMCs). In cultured rat aortic VSMCs, Ang II increased p66shc phosphorylation, which was inhibited by the Ang II receptor type I ($AT_1R$) inhibitor, valsartan ($10{\mu}M$), but not by the $AT_2R$ inhibitor, PD123319. TSA ($1{\sim}10{\mu}M$) inhibited Ang II-induced p66shc phosphorylation in VSMCs and in HEK293T cells expressing $AT_1R$. Taken together, these results suggest that TSA treatment inhibited vasoconstriction and hypertension via inhibition of Ang II-induced phosphorylation of p66shc through $AT_1R$.

• Journal of Preventive Medicine and Public Health
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• v.33 no.2
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• pp.199-207
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• 2000

Objectives : This study was peformed to identify the risk factors related to the development of hypertension in a rural area. Method : Total of 3,573 subjects in Chung-Song County were interviewed and examined in 1996. The study cohort comprised 2,580 hypertension-free subjects aged above 20. One-year follow up was completed for 1,781 subjects(69.0%) in 1997. General characteristics(age, gender, education level, economic status, marital status), the family history of hypertension, diet, alcohol, smoking, coffee, stress, past history of oral contraceptive and menopausal status in female, height, weight, waist and hip circumference, baseline blood pressure, and serum total cholesterol were considered as risk factors. Results : Multivariate analysis using logistic regression model indicated that age(RH=1.50, 95% CI; 1.15-1.96), the family history of hypertension(RR=2.11, 95% CI; 1.04-4.26), waist-hip ratio(WHR) (RR=2.09, 95%, CI; 1.15-3.79), and baseline systolic blood pressure(130-139/<120mmHg)(RR=3.34, 95% CI; 1.47-7.60) were significant risk factors associated with the development of hypertension above the borderline level in male. In female, age(RR=1.06, 95% CI; 1.03-1.09), change in menopausal status$(no{\rightarrow}yes/no{\rightarrow}no)$ (RR=3.32, 95% CI; 1.01-10.87), baseline systolic blood pressure(120-129/<120mmHg: RR=2.00, 95% CI; 1.02-3.90)(130-139/<120mmHg: RR=2.64, 95% CI; 1.34-5.20) and baseline diastolic blood pressure(85-89/<80mmHg)(RR=4.09, 95% CI; 1.86-8.96) were identified as risk factors. Conclusions : Age and high normal blood pressure were significant risk factors for the development of hypertension above the borderline level. In addition, the family history of hypertension and WHR in men, and the change of menopausal status in women might be significant risk factors in Korea.

• Journal of Chest Surgery
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• v.44 no.6
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• pp.432-436
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• 2011

We herein present a case of a successful correction of cor triatriatum associated with thrombotic pulmonary hypertension diagnosed in an adult female patient. We confirmed diagnosis using transthoracic and transesophageal echocardiography in addition to cardiac computed tomography and magnetic resonance imaging. Surgical repair comprised excision of the fibromuscular membranous septum in the left atrium, patch closure of an atrial septal defect, and reconstruction of the pulmonary arteries with a vascular graft. Cor triatriatum complicated pulmonary thrombotic hypertension with atrial septal defect is amenable to surgical correction with satisfactory results.

• Health Policy and Management
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• v.21 no.3
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• pp.414-424
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• 2011

The purpose of this study is to describe the characteristics associated with the hypertension educated population, and to develop and analyze a simple predictive model of the hypertension management education status. Based on the Korea National Health and Nutrition Examination Survey in 2008, a cross-sectional design was used in this study. An effective 1.165 adults(${\geq}30$) sample was divided into a participation group (n=66) and a non-participation group(n=1,099), and to compare demographic, socio-economic and health characteristics between two groups. Moreover, predictors associated with participation in hypertension education programs were identified by the logistic regression analysis. The participation rate in hypertension education in Korea is only 5.7% which is vastly low given the various programs were provided, and there are statistically significant differences between a participation group and a non-participation group in age(p=0.050), marital status(p=0.002), education level(p=0.000), and residence area(p=0.037). Furthermore, age for 40-49 years(OR : 0.207), education level of high school(OR : 2.579) and college(OR : 6.417), duration of hypertension(OR : 1.044), CVA(OR : 2.463), and blood pressure(OR : 1.041) are statistically significant predictors associated with the participation in hypertension education programs. To increase the participation of hypertension education program, variables such as age, education level, duration of hypertension, CVA, and blood pressure are more concerned. And, high-risk patients and family members need targeted outreach programs.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.880-892
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• 2009

Objectives : This study is about a comparison of controlled and uncontrolled hypertension groups regarding pulse shape and quality of life. We aimed to find out if pulse shape would be able to help with hypertension treatment and care. Methods : We surveyed "controlled and uncontrolled hypertension patients" using SF-36, HTN QoL (measurement scale for the quality of life in hypertensive patients) and 3-D MAC pulse analyzer for pulse shape. Results : The uncontrolled hypertension group tended to have a sink pulse in the left cun. right guan & chi parts compared to the controlled hypertension group. Within the controlled hypertension group, patients who had a float pulse shape in both guan parts had a higher quality of life than patients who had a normal pulse shape. And the patients who had a normal pulse shape in both chi parts had a higher quality of life than patients with a slow or fast pulse shape. Within the uncontrolled hypertension grouP. the patients who had a normal pulse shape in right guan part had a higher quality of life than those with a choppy pulse shape. Nevertheless, these results were limited to only a few quality of life issues and were inconsistent in relation to specific pulse shapes. Conclusion : If we have more samples and better methods for collecting data, we will have better results, allowing us to improve our ability to predict and treat hypertension.

• Journal of Preventive Medicine and Public Health
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• v.55 no.6
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• pp.506-519
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• 2022

Objectives: This study aimed to analyze the associations of income, marital status, and health behaviors with hypertension in male and female over 40 years of age in the Korea. Methods: The data were derived from the Korean Genome and Epidemiology Study (KoGES; 4851-302) which included 211 576 participants. To analyze the relationships of income, marital status, and health behaviors with hypertension in male and female over 40 years of age, multiple logistic regression was conducted with adjustments for these variables. Results: The prevalence of hypertension increased linearly as income decreased. The odds ratio for developing hypertension in people with an income of <0.5 million Korean won (KRW) compared to ≥6.0 million KRW was 1.55 (95% confidence interval [CI], 1.25 to 1.93) in the total population, 1.58 (95% CI, 1.27 to 1.98) in male, and 1.07 (95% CI, 0.35 to 3.28) in female. The combined effect of income level and marital status on hypertension was significant. According to income level and marital status, in male, low income and divorce were most associated with hypertension (1.76 times; 95% CI, 1.01 to 3.08). However, in female, the low-income, married group was most associated with hypertension (1.83 times; 95% CI, 1.71 to 1.97). Conclusions: The results of this study show that it is necessary to approach male and female marital status separately according to income in health policies to address inequalities in the prevalence of hypertension.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.141-146
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• 2002

Objectives : This study was peformed in order to assess the incidence of hypertension based on two-years follow-up of a rural hypertension-free cohort in Korea. Methods : The study cohen comprised 2,580 subjects aged above 20 (1,107 men and 1,473 women) of Chung-Song County in Kyungpook Province judged to be hypertensive-free at the baseline examination in 1996. For each of two examinations in the two-year follow-up, those subjects free of hypertension were followed for the development of hypertension to the next examination one year (1997) and two years later (1998). The drop-out rate was 24.7% in men and 19.6% in women. Hypertension was defined as follows 1) above mild hypertension as a SBP above 140 mmHg or a DBP above 90 mmMg,2) above moderate hypertension as a SBP above 160 mmHg or a DBP above 100 mmHg or when the participant reported having used antihypertensive medication after beginning this survey. Results : The age-standardized incidence of above mild hypertension was 6 per 100 person years (PYS) in men and that of above moderate hypertension was 1.2. In women, the age-standardized rate for above mild hypertension was 5.7 and 1.5 for above mild and moderate hypertension, respectively. However, the rates of incidence as calculated by the risk method were 4.8% and 1.0% in men and 4.6%, 1.2% in women, respectively. In both genders, incidence was significantly associated with advancing age(p<0.01), In men, the incidences of above moderate hypertension by age group were 0.5 per 100 PYS aged 20-39, 0.7 aged 40-49, 1.7 aged 50-59, 3.6 aged 60-69, and 5.8 aged above 70(p<0.01). In women, those the incidence measured 0.6 per 100 PYS aged 20-39, 1.8 aged 40-49, 1.3 aged 50-59, 3.3 aged 60-69, and 5.6 aged above 70(p<0.01). After age 60, the incidence of hypertension increased rapidly. Conclusions : The incidence data of hypertension reported in this study may serve as a reference data for evaluating the impact of future public efforts in the primary prevention of hypertension in Korea.

• The Journal of Korean Society for School & Community Health Education
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• v.17 no.1
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• pp.23-33
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• 2016

Objectives: The purpose of this study is analysing the influence of how health behavior such as smoking, drinking, and consuming salt and obesity affects to blood pressure and providing useful data for preventing ischemic heart disease of Peru which is main cause of death since 2012 and promoting healthy lifestyle of community. Methods: At the selected four districts in Lima and Callao region of Peru by KOICA Peru office, survey was conducted among adults over the age of 18. Excepted 19 incomplete people for the missing, 686 people were analysed in this survey. Results: There was no significant relationship between blood pressure and drinking and salt intake. By regression analysis, systolic blood pressure was significantly related with gender, age and abdominal obesity and diastolic blood pressure was significantly related with gender and abdominal obesity. Conclusions: As a result, diastolic and systolic blood pressure are mainly affected by waist circumference and gender. Therefore, It's need to be classifying male into vulnerable groups in the occurrence of hypertension and providing health education and information about hypertension to them. For improving health status of vulnerable group, awareness of hypertension prevention and changing unhealthy lifestyle to healthy lifestyle activities are necessary. In the end, it is necessary to prevent abdominal obesity through periodic health education.

• Clinical and Experimental Pediatrics
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• v.56 no.3
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• pp.116-124
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• 2013

Purpose: Tumor necrosis factor (TNF)-${\alpha}$ is thought to contribute to pulmonary hypertension. We aimed to investigate the effect of infliximab (TNF-${\alpha}$ antagonist) treatment on pathologic findings and gene expression in a monocrotaline-induced pulmonary hypertension rat model. Methods: Six-week-old male Sprague-Dawley rats were allocated to 3 groups: control (C), single subcutaneous injection of normal saline (0.1 mL/kg); monocrotaline (M), single subcutaneous injection of monocrotaline (60 mg/kg); and monocrotaline + infliximab (M+I), single subcutaneous injection of monocrotaline plus single subcutaneous injection of infliximab (5 mg/kg). The rats were sacrificed after 1, 5, 7, 14, or 28 days. We examined changes in pathology and gene expression levels of TNF-${\alpha}$, endothelin-1 (ET-1), endothelin receptor A (ERA), endothelial nitric oxide synthase (eNOS), matrix metalloproteinase (MMP) 2, and tissue inhibitor of matrix metalloproteinase (TIMP). Results: The increase in medial wall thickness of the pulmonary arteriole in the M+I group was significantly lower than that in the M group on day 7 after infliximab treatment (P<0.05). The number of intraacinar muscular arteries in the M+I group was lower than that in the M group on days 14 and 28 (P<0.05). Expression levels of TNF-${\alpha}$, ET-1, ERA, and MMP2 were significantly lower in the M+I group than in the M group on day 5, whereas eNOS and TIMP expressions were late in the M group (day 28). Conclusion: Infliximab administration induced early changes in pathological findings and expression levels of TNF-${\alpha}$, and MMP2 in a monocrotaline-induced pulmonary hypertension rat model.